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elderly imbalance electrolyte

Jason A Horowitz, Amit Jain, Varun Puvanesarajah, Rabia Qureshi, Hamid Hassanzadeh
OBJECTIVE: Identify the independent risk factors, additional length of stay, and additional cost associated with postoperative ileus following anterior lumbar interbody fusion in the elderly. METHODS: The PearlDiver Patient Records Database (Young & Ellison, LLC, Colorado Springs, CO) was queried for all Medicare patients 65 years of age and older undergoing 1 or 2 level primary elective anterior lumbar interbody fusion from 2005-2014. Independent risk factors, additional length of stay, and additional cost associated with postoperative ileus were evaluated with multivariate analysis...
April 10, 2018: World Neurosurgery
Praful Kilaru, A Ramachandra Reddy, Maryada Venketeshwar Reddy, Brijesh Kidiyoor, Vinay Mathew Joseph, Annapareddy Venkata Gurava Reddy
Introduction: Total knee replacement is a common surgical procedure in the elderly. The number of surgeries has increased owing to the increasing life expectancy of the population and better functional outcomes postsurgery. Postoperative cognitive dysfunction (POCD) is an identified entity postsurgery in elderly but most of the studies have been on patients undergoing cardiac and other nonorthopaedic surgeries. The studies have shown variable incidence due to selection bias. We studied the incidence and probable predictive factors of POCD in elderly Indian population undergoing total knee replacement under spinal anesthesia...
January 2018: Anesthesia, Essays and Researches
Li Wang, Ping Dong, Yi Zhang, Bole Tian
RATIONALE: Gallstone ileus is a rare complication of cholecystolithiasis. It has a female predominance and can result in high mortality rates. PATIENT CONCERNS: A 71-year-old woman complaining of recurrent vomiting and vague epigastralgia for > 2 weeks presented to our department. DIAGNOSIS: Based on her physical examination, laboratory test results and radiographic findings (the typical Rigler's triad), she was diagnosed with gallstone ileus caused by multiple ectopic stones...
November 2017: Medicine (Baltimore)
Atta Abbas Naqvi, Amna Shah, Rizwan Ahmad, Niyaz Ahmad
INTRODUCTION: The ailments afflicting the elderly population is a well-defined specialty of medicine. It calls for an immaculately designed health-care plan to treat diseases in geriatrics. For chronic illnesses such as diabetes mellitus (DM), coronary heart disease, and hypertension (HTN), they require proper management throughout the rest of patient's life. An integrated treatment pathway helps in treatment decision-making and improving standards of health care for the patient. CASE PRESENTATION: This case describes an exclusive clinical pharmacist-driven designing of an integrated treatment pathway for a post-coronary artery bypass grafting (CABG) geriatric male patient with DM type I and HTN for the treatment of hypoglycemia and electrolyte imbalance...
July 2017: Journal of Pharmacy & Bioallied Sciences
Ching-Fang Chien, Poyin Huang, Sun-Wung Hsieh
Quetiapine is an atypical antipsychotic agent which is also prescribed for delirium due to its anti-dopaminergic effects; aphasia is an unusual side effect associated with the drug. Here, we report the case of an 83-year-old woman who was prescribed quetiapine (50 mg per day) for delirium. Unexpected, global aphasia occurred 3 days after treatment began. Complete recovery occurred following discontinuation of the drug. A brain computed tomography scan excluded intracranial hemorrhage and the laboratory results confirmed that no exacerbation of infection or electrolyte imbalances were present...
2017: Neuropsychiatric Disease and Treatment
Sibel Ocak Serin, Gulsah Karaoren, Yildiz Okuturlar, Ethem Unal, Seda Ahci, Eda Karakoc, Sema Ucak Basat
INTRODUCTION: Re-feeding Syndrome (RS) is a deadly complication, which can be encountered during "refeeding" of malnourished patients. In these patients, thiamin deficiency may develop and "risk awareness" is the most significant factor in the management of these patients. In this case report, the treatment is presented of an elderly patient who was diagnosed with RS and followed-up in the intensive care unit (ICU) due to resistant fluidelectrolyte imbalance. CASE: An 87-year-old elderly woman was admitted to the hospital due to aspiration pneumonia...
March 2017: Asia Pacific Journal of Clinical Nutrition
Francisco Aguilar-Espinosa, José Luis Gálvez-Romero, Jesús Falfán-Moreno, Gustavo Adolfo Guerrero-Martínez, Facundo Vargas-Solís
BACKGROUND: Gallstone ileus is a non-strangulated mechanical obstruction of the small bowel or colon as a result of the passage of gallstones through a biliary enteric fistula. It is a rare complication of cholelithiasis, affects patients over 65 years, and the disease occurs predominantly in females. Preoperative diagnosis is difficult due to the lack of specific signs and symptoms in elderly patients with multiple comorbidities. CLINICAL CASE: A 93-year-old female presenting with a one-week history of upper gastrointestinal bleeding, electrolyte imbalance and community- acquired pneumonia pneumonia...
December 2017: Cirugia y Cirujanos
S Bardak, K Turgutalp, M B Koyuncu, H Harı, I Helvacı, D Ovla, M Horoz, S Demir, A Kıykım
PURPOSE: Electrolyte imbalance is a common problem affecting the elderly. Increased number of comorbidities and frequent use of drugs may contribute to increased risk of hypokalemia in the elderly. This study was performed to investigate the prevalence of community-acquired hypokalemia (CAH), risk factors for its development, related factors with hypokalemia, and morbidities and all-cause mortality rates (MR) of CAH in the elderly patients. METHODS: Total of 36,361 patients aged above 65 years were screened retrospectively...
March 2017: International Urology and Nephrology
Leyi Cai, Te Wang, Lu Di, Wei Hu, Jianshun Wang
BACKGROUND: Hip fracture is a severe and common injury that occurs predominantly in the elderly. Blood loss in the perioperative period is associated with a greater risk of dying in anaemic patients. The aim of the study was to explore the best way to treat stable intertrochanteric fractures, taking hidden blood loss into account. METHODS: This prospective, randomised blinded study included patients aged over 65 years with stable intertrochanteric fractures (Evans grades I and II)...
November 15, 2016: BMC Musculoskeletal Disorders
Ce Yang, Jie Gao, Juan Du, Haiyan Wang, Jianxin Jiang, Zhengguo Wang
BACKGROUND: Rescue after a maritime disaster remains a great challenge in emergency medicine. OBJECTIVE: We performed an overview of rescue efforts among the victims in the sunken cruise ship Eastern Star in the 2015 Changjiang River marine disaster, as well as possible preventive measures in maritime transport situations. METHODS: The rescue records of 454 victims of the sunken ship were analyzed retrospectively. Their demographic data, rescue effects, accident inducement, and injury disposition were reviewed...
February 2017: Journal of Emergency Medicine
Mauro Giordano, Tiziana Ciarambino, Pietro Castellino, Lorenzo Malatino, Salvatore Di Somma, Gianni Biolo, Giuseppe Paolisso, Luigi Elio Adinolfi
OBJECTIVE: The objective of the study is to investigate the prevalence of electrolyte imbalance (EI) in the emergency department (ED) with systemic diseases in different decades of life. METHODS: We enrolled patients admitted to the ED. The population study included 7941 patients, subdivided in 3 groups: young group (Y), middle-aged group (MA), and elderly group (E). RESULTS: We observed EI in 13.7% of the whole population. Hyponatremia (hNa+) is the most frequent EI (44%) followed by hypokalemia (hK+) (39%), hyperkalemia (HK+) (13%), and hypernatremia (HNa+) (4...
October 2016: American Journal of Emergency Medicine
Andrea Winquist, Andrew Grundstein, Howard H Chang, Jeremy Hess, Stefanie Ebelt Sarnat
PURPOSE: Extreme heat events will likely increase in frequency with climate change. Heat-related health effects are better documented among the elderly than among younger age groups. We assessed associations between warm-season ambient temperature and emergency department (ED) visits across ages in Atlanta during 1993-2012. METHODS: We examined daily counts of ED visits with primary diagnoses of heat illness, fluid/electrolyte imbalances, renal disease, cardiorespiratory diseases, and intestinal infections by age group (0-4, 5-18, 19-64, 65+years) in relation to daily maximum temperature (TMX) using Poisson time series models that included cubic terms for TMX at single-day lags of 0-6 days, controlling for maximum dew-point temperature, time trends, week day, holidays, and hospital participation periods...
May 2016: Environmental Research
Lukshe Kanagaratnam, Moustapha Dramé, Thierry Trenque, Nadia Oubaya, Pierre Nazeyrollas, Jean-Luc Novella, Damien Jolly, Rachid Mahmoudi
Elderly subjects with cognitive disorders are at particularly high risk of adverse drug reactions (ADRs). The objectives of our systematic review were to describe the prevalence of ADRs in elderly patients with cognitive disorders, the different types of ADRs and the medications suspected of involvement; to describe whether the ADRs were preventable or not, and to identify risk factors for occurrence of ADRs in this population. A bibliographic search was performed in the following databases: PubMed, Embase, Google Scholar, Opengrey and Scopus...
March 2016: Maturitas
Susan Canaday, John Rompala, John Rowles, Josh Fisher, David Holt
Serum sodium concentration affects every cell in the body with respect to cellular tonicity. Hyponatremia is the most frequent electrolyte abnormality encountered, occurring at clinical admission in 22% of elderly patients. Any rapid correction of chronic severe hyponatremia can result in rapid cellular shrinking due to loss of intracellular free water. This is commonly associated with paralysis and severe brain damage due to osmotic demyelination syndrome (ODS). ODS occurs because the body has the ability to compensate for cellular fluid shifts due to chronic hyponatremia (by a decrease in brain concentration of several ions, amino acids, and organic osmolytes)...
December 2015: Journal of Extra-corporeal Technology
Chia-Ter Chao, Hung-Bin Tsai, Chia-Yi Wu, Yu-Feng Lin, Nin-Chieh Hsu, Jin-Shing Chen, Kuan-Yu Hung
Acute kidney injury (AKI) is associated with higher hospital mortality. However, the relationship between geriatric AKI and in-hospital complications is unclear. We prospectively enrolled elderly patients (≥65 years) from general medical wards of National Taiwan University Hospital, part of whom presented AKI at admission. We recorded subsequent in-hospital complications, including catastrophic events, incident gastrointestinal bleeding, hospital-associated infections, and new-onset electrolyte imbalances...
2015: Scientific Reports
Sunil K Dash, Ranajit Panigrahi, Nishit Palo, Ashok Priyadarshi, Manas Biswal
Elderly patients with hip fracture constitute Single Largest Group of Emergency Orthopaedics Admissions. In 2050, 6.26 million hip fractures worldwide, approximately 50%, will occur in Asia. Only small number of reports on incidence of hip fractures in the Asian population exist. India lacks data registry for fragility hip fractures, therefore, the magnitude and standard of patient care are not known. A prospective multicenter study was conducted from January 2012 to April 2014 to describe population-based longitudinal trends, namely, age-specific incidence, fracture type, timing of presentation, kilometers traveled, timing of surgery, hospital stay, man hours lost, pressure ulcers, weight bearing, 30-day return, 3-month mortality, and so on, of fragility hip fractures...
March 2015: Geriatric Orthopaedic Surgery & Rehabilitation
K Westaway, O Frank, A Husband, A McClure, R Shute, S Edwards, J Curtis, D Rowett
WHAT IS KNOWN AND OBJECTIVE: Hot days are increasingly common and are often associated with increased morbidity and mortality, especially in the elderly. Most heat-related illness and heat-related deaths are preventable. COMMENT: Medicines may accentuate the risk of dehydration and heat-related illness, especially in elderly people taking multiple medicines, through the following mechanisms: diuresis and electrolyte imbalance, sedation and cognitive impairment, changed thermoregulation, reduced thirst recognition, reduced sweat production, and hypotension and reduced cardiac output...
August 2015: Journal of Clinical Pharmacy and Therapeutics
Ryoma Michishita, Kazuko Ishikawa-Takata, Eiichi Yoshimura, Rikako Mihara, Masahiro Ikenaga, Kazuhiro Morimura, Noriko Takeda, Yosuke Yamada, Yasuki Higaki, Hiroaki Tanaka, Akira Kiyonaga
It is well known that imbalances in the dietary electrolytes are associated with a significantly higher incidence of cardiovascular disease (CVD). On the other hand, a prolonged heart rate corrected-QT (QTc) interval is associated with an increased risk of cardiac autonomic nervous system dysfunction, the incidence of CVD and sudden cardiac death. This study was designed to clarify the association between the nutritional status and the QTc interval in elderly subjects. The subjects included 119 elderly subjects (46 males and 73 females, age; 72...
2015: Journal of Nutritional Science and Vitaminology
Matthew B Fortes, Julian A Owen, Philippa Raymond-Barker, Claire Bishop, Salah Elghenzai, Samuel J Oliver, Neil P Walsh
OBJECTIVES: Dehydration in older adults contributes to increased morbidity and mortality during hospitalization. As such, early diagnosis of dehydration may improve patient outcome and reduce the burden on healthcare. This prospective study investigated the diagnostic accuracy of routinely used physical signs, and noninvasive markers of hydration in urine and saliva. DESIGN: Prospective diagnostic accuracy study. SETTING: Hospital acute medical care unit and emergency department...
March 2015: Journal of the American Medical Directors Association
Kirsten Cumming, Stephen McKenzie, Graeme E Hoyle, James D Hutchison, Roy L Soiza
BACKGROUND: Hyponatremia (serum sodium < 135 mmol/L) is the commonest electrolyte imbalance encountered in clinical practice. It is associated with multiple poor clinical outcomes including increased length of hospital stay, institutionalization and mortality. Prevalence of hyponatremia is higher in frail patient groups, and elderly patients with fragility fractures (EPFF) are particularly susceptible. This study aimed to establish the impact of hyponatremia on total length of inpatient stay (TLOS), need for inpatient rehabilitation and mortality in EPFF...
January 2015: Journal of Clinical Medicine Research
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